Skip to main content

Advertisement

SpringerLink
Log in

Comparison of the Scar Prevention Effect Between a Carbon Dioxide Fractional Laser and a Continuous Ablative Carbon Dioxide Laser with a 595-nm Nd:YAG Laser

  • Original Article
  • Non-Surgical Aesthetic
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Purpose

A linear surgical scar, when located in the head and neck region, can be a significant cosmetic concern. Laser skin resurfacing with a fractional laser and a pulsed dye laser has been proven to be useful for treating such scars. As alternatives, we used a classic ablative CO2 laser in continuous mode with a 1-mm spot size and a 595-nm Nd:YAG laser. We investigated the effect of the combination of the continuous CO2 laser and 595-nm Nd:YAG laser and compared it to the effect of fractional CO2 laser monotherapy on linear scars.

Methods

This was a retrospective, case-controlled study designed to compare the efficacy between fractional CO2 laser therapy and combination therapy with a conventional CO2 laser in continuous mode and a 595-nm Nd:YAG laser. Treatment efficacy was evaluated by two different scar scales: the Stony Brook Scar Evaluation Scale (SBSES) and the modified Vancouver Scar Scale (mVSS). Laser treatments were performed every month until the 6th month after surgery.

Results

The SBSES and mVSS scores improved over time in both the monotherapy and the combination therapy (P < 0.001). No significant differences were found between the therapies for all the subcategories of the SBSES. However, among all the subcategories of the mVSS, pigmentation showed a better prognosis with combination therapy (P = 0.04).

Conclusion

Monotherapy and combination therapy can provide similar positive effects on linear scar improvement after repeated treatment, whereas combination therapy exerts more favorable anti-pigmentation effects than monotherapy. The combination of a continuous ablative CO2 laser with a 595-nm Nd:YAG laser can be used as a favorable alternative to a fractional CO2 laser. The 1-mm spot size of the CO2 laser beam may mimic the fractional laser form and offer more effective results for linear incision scars.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Capon A, Iarmarcovai G, Gonnelli D, Degardin N, Magalon G, Mordon S (2010) Scar prevention using Laser-Assisted Skin Healing (LASH) in plastic surgery. Aesthet Plast Surg 34:438–446

    Article  Google Scholar 

  2. Gold MH, McGuire M, Mustoe TA et al (2014) Updated international clinical recommendations on scar management: part 2—algorithms for scar prevention and treatment. Dermatol Surg 40:825–831

    CAS  PubMed  Google Scholar 

  3. Kim DH, Ryu HJ, Choi JE, Ahn HH, Kye YC, Seo SH (2014) A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars. Dermatol Surg 40:973–978

    Article  CAS  PubMed  Google Scholar 

  4. Buelens S, Van Hove AS, Ongenae K et al (2017) Fractional carbon dioxide laser of recent surgical scars in the head and neck region: a split-scar, evaluator-blinded study. Dermatol Surg 43(Suppl 1):S75–S84

    Article  CAS  PubMed  Google Scholar 

  5. Tanzi EL, Wanitphakdeedecha R, Alster TS (2008) Fraxel laser indications and long-term follow-up. Aesthet Surg J 28:675–678

    Article  PubMed  Google Scholar 

  6. Nouri K, Jimenez GP, Harrison-Balestra C, Elgart GW (2003) 585-nm pulsed dye laser in the treatment of surgical scars starting on the suture removal day. Dermatol Surg 29:65–73

    PubMed  Google Scholar 

  7. Choe JH, Park YL, Kim BJ et al (2009) Prevention of thyroidectomy scar using a new 1,550-nm fractional erbium-glass laser. Dermatol Surg 35:1199–1205

    Article  CAS  PubMed  Google Scholar 

  8. Taniguchi Y, Muraoka M, Harada T, Ito N (2003) Pulsed dye laser treatment for linear scars with concave and erythematous appearance. Aesthet Plast Surg 27:205–208

    Article  Google Scholar 

  9. Ts A, Cm W (1995) Treatment of keloid sternotomy scars with 585 nm flashlamp-pumped pulsed-dye laser. Lancet 13(345):1198–1200

    Google Scholar 

  10. Panchaprateep R, Munavalli G (2015) Low-fluence 585 nm Q-switched Nd:YAG laser: a novel laser treatment for post-acne erythema. Lasers Surg Med 47:148–155

    Article  PubMed  Google Scholar 

  11. Bowes LE, Nouri K, Berman B et al (2002) Treatment of pigmented hypertrophic scars with the 585 nm pulsed dye laser and the 532 nm frequency-doubled Nd:YAG laser in the Q-switched and variable pulse modes: a comparative study. Dermatol Surg 28:714–719

    PubMed  Google Scholar 

  12. Fearmonti R, Bond J, Erdmann D, Levinson H (2010) A review of scar scales and scar measuring devices. Eplasty 21(10):e43

    Google Scholar 

  13. Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 34:426–438

    Article  PubMed  Google Scholar 

  14. Geronemus RG (2006) Fractional photothermolysis: current and future applications. Lasers Surg Med 38:169–176

    Article  PubMed  Google Scholar 

  15. Jared Christophel J, Elm C, Endrizzi BT, Hilger PA, Zelickson B (2012) A randomized controlled trial of fractional laser therapy and dermabrasion for scar resurfacing. Dermatol Surg 38:595–602

    Article  CAS  PubMed  Google Scholar 

  16. Hedelund L, Haak CS, Togsverd-Bo K, Bogh MK, Bjerring P, Haedersdal M (2012) Fractional CO2 laser resurfacing for atrophic acne scars: a randomized controlled trial with blinded response evaluation. Lasers Surg Med 44:447–452

    Article  PubMed  Google Scholar 

  17. Majid I, Imran S (2014) Fractional CO2 laser resurfacing as monotherapy in the treatment of atrophic facial acne scars. J Cutan Aesthet Surg 7:87–92

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ts A, Ca N (1998) Pulsed dye laser treatment of hypertrophic burn scars. Plast Reconstr Surg 102:2190–2195

    Article  Google Scholar 

  19. Khatri KA, Mahoney DL, McCartney MJ (2011) Laser scar revision: a review. J Cosmet Laser Ther 13:54–62

    Article  PubMed  Google Scholar 

  20. Liu A, Moy RL, Ozog DM (2011) Current methods employed in the prevention and minimization of surgical scars. Dermatol Surg 37:1740–1746

    Article  CAS  PubMed  Google Scholar 

  21. Chan HH, Wong DS, Ho WS, Lam L, Wei W (2004) The use of pulsed dye laser for the prevention and treatment of hypertrophic scars in Chinese persons. Dermatol Surg 30:987–994

    Article  PubMed  Google Scholar 

  22. Sobanko JF, Vachiramon V, Rattanaumpawan P, Miller CJ (2015) Early postoperative single treatment ablative fractional lasing of Mohs micrographic surgery facial scars: a split-scar, evaluator-blinded study. Lasers Surg Med 47:1–5

    Article  PubMed  Google Scholar 

  23. Jung JY, Jeong JJ, Roh HJ et al (2011) Early postoperative treatment of thyroidectomy scars using a fractional carbon dioxide laser. Dermatol Surg 37:217–223

    Article  CAS  PubMed  Google Scholar 

  24. Hong SC, Park ES, Kim YB, Nam SM (2014) Effects of minimizing scar formation by early fractional CO2 laser resurfacing. Arch Aesthet Plast Surg 20:109–113

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea

    Seong Joo Lee, Jun Won Lee, Seong Hwan Kim, In Suck Suh & Hii Sun Jeong

Authors
  1. Seong Joo Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jun Won Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seong Hwan Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. In Suck Suh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hii Sun Jeong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hii Sun Jeong.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, S.J., Lee, J.W., Kim, S.H. et al. Comparison of the Scar Prevention Effect Between a Carbon Dioxide Fractional Laser and a Continuous Ablative Carbon Dioxide Laser with a 595-nm Nd:YAG Laser. Aesth Plast Surg 43, 213–220 (2019). https://doi.org/10.1007/s00266-018-1210-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-018-1210-2

Keywords

Search

Navigation